Active NPI
Jerome Glazer OD
- Optometrist
- Wethersfield, CT
National Provider Identifier
1265618169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 722
- Legal business name
- JEROME GLAZER OD
- Practice address
- 67 Wells Rd
Wethersfield, CT 06109-3043 - Phone
- (860) 529-5429
- Fax
- (860) 563-5202
- NPI assigned
- Jan 10, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jerome I Glazer, O.D.
- Title
- Owner
- Phone
- (860) 529-5429
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 722 | CT | Primary |
Addresses
Primary practice location
67 Wells Rd
Wethersfield, CT 06109-3043
Mailing address
67 Wells Rd
Wethersfield, CT 06109-3043
Phone (860) 529-5429
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 090000722CT01 | Other | CT | ANTHEM BLUE CROSS OF CT |
| 0V0193 | Other | CT | HEALTH NET |
| 13122 | Other | CT | SPECTERA |
| P386567 | Other | CT | OXFORD |
| 004023875 | Medicaid | CT | |
| C3E541 | Other | CT | EMPIRE BLUE CROSS |
| 138028 | Other | CT | WELLCARE OF CT |
| 00402387501 | Other | CT | BLUE CARE FAMILY PLAN |
| 912918 | Other | CT | BLOCK MEDICAIDE |
| 112728 | Other | CT | EYEMED |
| 1497774301 | Other | CT | NPI |
| 17098 | Other | CT | AVESIS |
| 773845 | Other | CT | CONNECTICARE |
National Provider Directory
National Provider DirectoryLocations
67 Wells Rd
Wethersfield, CT 06109
Phone (860) 529-5429
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Wethersfield, CT
- NPI 1497774301
-
- Optometrist
- Wethersfield, CT
- NPI 1154492718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199923200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1250467200000",
"number": "1265618169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 WELLS RD",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061093043",
"telephone_number": "860-529-5429",
"fax_number": "860-563-5202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 WELLS RD",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061093043",
"telephone_number": "860-529-5429",
"fax_number": "860-563-5202"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JEROME GLAZER OD",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-10",
"last_updated": "2009-08-17",
"status": "A",
"authorized_official_last_name": "GLAZER",
"authorized_official_first_name": "JEROME",
"authorized_official_middle_name": "I",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "860-529-5429",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "CT",
"license": "722",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS OF CT",
"identifier": "090000722CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "0V0193",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "13122",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P386567",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004023875",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BLUE CROSS",
"identifier": "C3E541",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE OF CT",
"identifier": "138028",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE FAMILY PLAN",
"identifier": "00402387501",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK MEDICAIDE",
"identifier": "912918",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "112728",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1497774301",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVESIS",
"identifier": "17098",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "773845",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wethersfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.